RETINAL PIGMENT EPITHELIAL DETACHMENTS DEVOID OF RETINAL PIGMENT EPITHELIUM.

Purpose: To describe two patients with chronic central serous chorioretinopathy showing what appeared to be retinal pigment epithelium detachments lacking imaging findings consistent with retinal pigment epithelium (RPE) over the elevation.

Methods: The patients underwent comprehensive ophthalmic examination, including multicolor fundus photography, fundus autofluorescence, and spectral-domain optical coherence tomography.

Results: A 70-year-old man and a 58-year-old man, diagnosed with chronic central serous chorioretinopathy, showed pigment epithelium detachment-like lesions that were hypoautofluorescent, suggesting an absence of RPE. Spectral-domain optical coherence tomography B scans showed serous, dome-shaped elevations composed of a narrow, mildly hyperreflective band (9-10- µ m thick) that demonstrated hypertransmission of light. The material that constituted the elevation was contiguous with the outer portion of the RPE band at the lesion borders.

Conclusion: Based on the multimodal imaging findings, we hypothesize that these pigment epithelial detachments have lost the RPE. A thin layer of material that could represent a residual layer of basal laminar deposit produced by the RPE remains overlying the detachments, possibly accounting for their dome shape and structural stability.